Infection Control and Asepsis 1
Introduction to Infection Control Nosocomial infections are acquired by patients in some kind of health care facility Center for Disease Control (CDC), the Joint Commission, state regulatory agencies, and each health care institution are required to develop and implement infection control policies. Infection control department have personnel that work on this on regular basis in order to stay on top of things 2
Asepsis Medical Asepsis-- the use of practices aimed at destroying pathological organisms after they leave the body; employed in the care of patients with infectious diseases to prevent reinfection of the patient and to avoid the spread of infection from one person to another. Surgical Asepsis-- the exclusion of all microorganisms before they can e nter an open surgical wound or contaminate a sterile field during surgery or a procedure 3
Infection Control Stops the spread of disease to: Medical personnel Patients Breaks the chain of disease transmission CDC and OSHA Establish and enforce infection control guidelines and regulations What is the difference between a regulation and a guideline? 4
5
Microorganisms Pathogenic Disease-producing microorganisms Nonpathogenic Not disease-producing microorganisms Limit the growth of pathogens Help maintain homeostasis in the body Can become disease producing if transported to an area outside their normal environment 6
Growth Requirements for Microorganisms Nutrients: nitrogen and carbon Darkness: no light or low light requirement Temperature: body temperature of 98.6 F ideal for growth ph: neutral 7 preferred Gases: need for oxygen depends on organism Moisture: prefer damp environment 7
What is a nosocomial infection? 8
Classes of Disease-Causing Microorganisms Bacteria: single-celled microorganisms Fungi: include yeast and molds Rickettsiae: parasites that need a host to survive Protozoa: single-celled animals Viruses: reproduce only if within a living cell 9
Cocci: round (spherical) Bacteria Classifications Diplococci: occur in pairs (gonorrhea) Streptococci: occur in chains (strep throat) Staphylococci: occur in clusters (acne, boils, bacterial pneumonia) Bacilli: rod shaped, occur singly in pairs and chains (typhoid, diphtheria, TB) Spores (hard-walled capsules) Spirilla: spiral, corkscrew shaped (syphilis) 10
STAPH STREP VIRUS 11
What are the three shapes of bacteria? 12
Chain of Infection Infectious Organism Reservoir An infected person carries the disease-causing germs Route of exit Exit body through urine, feces, saliva, blood, tears Method of transmission Direct and/or indirect contact Route of entry Germs enter via nose, mouth, eyes, broken skin Susceptible host Person, insect, or animal infected by microorganism 13
Chain of Infection (cont.) 14
What are the six components of the Chain of Infection? 15
MODES OF TRANSMISSION Contact Mononucleosis Direct or Indirect Airborne Influenza Droplet Tuberculosis, Chickenpox Vector Fleas, Ticks, Mosquitos 16
Signs, Symptoms of Infection Localized infections Redness, pain, warmth, swelling, and possibly pus Generalized infections May not show all signs apparent in localized infections Pain may be mild to severe depending on its location Warmth is generally expressed as fever Malaise Anorexia Prostration 17
Centers for Disease Control and Prevention (CDC) Part of the Public Health Service and U.S. Department of Health and Human Services Universal Precautions in 1987 Guidelines for protecting health care workers from bloodborne infections and HIV Standard Precautions in 1996 New guidelines for clients and patients attending health care facilities 18
What are signs and symptoms of a localized infection? 19
20
21
Occupational Safety and Health Administration (OSHA) Mandates and enforces use of Standard Precautions Requires all employers to provide a safe working environment for their employees 22
Occupational Safety and Health Administration (OSHA) (cont.) Requires training for management of: Hazardous waste Material Safety Data Sheet (MSDS) Infectious waste Standard Precautions OSHA s Occupational Exposure to Bloodborne Pathogens Standard Effective since 1992 23
OSHA Needlestick Safety and Prevention Act The Needlestick Safety and Prevention Act mandated that the 1991 Bloodborne Pathogens Standard be revised to strengthen the requirements related to the use of safetyengineered sharp devices. Requires employers to identify, evaluate and make use of effective safer devices. For needle use it requires a built-in safety feature or mechanism that allows a single handed method of causing the needle to be permanently covered. The law mandated that employers allow front line employees to evaluate and select the equipment they were most comfortable with. Employers must maintain an injury log which will include the brand name of the device used which caused the injury. 24
Who is responsible for ensuring that employers follow safety standards? 25
Procedure: Practice Standard Precautions Select and assemble appropriate personal protective equipment (PPE) Identify body substance isolation procedures Apply transmission-based precautions Describe Standard Precautions as they apply to all body fluids Relate the importance of continuing education for Standard Precautions Develop exposure and postexposure control plan 26
How does someone know what PPE to used with a patient? 27
Normal flora Normal Flora Versus Transient Flora Usually nonpathogenic Grows on the surface of the skin Transient flora Often pathogenic Easily picked up on hands May be removed by washing 28
Cleaning Methods Disinfectant is a chemical compound used or remove or kill pathogenic organisms, they are regulated by the EPA. is used on surfaces and instruments, but are too caustic for direct use on human skin. Antiseptics are chemicals used to inhibit the growth and development of microorganisms, but not necessarily kill them. may be used on human skin. Bacteriocidal causing the death of bacteria Sterilization the process of destroying all microorganisms and their pathogenic products 29
Maintaining Hand Hygiene Handwashing Using soap and water Antiseptic handwash Using antiseptic soap and water Antiseptic hand rub Apply antiseptic hand rub (alcohol-based) Surgical handwash or surgical scrub Use antiseptic preparation for extended period 30
Procedure: Handwashing for Medical Asepsis Remove rings and watch Microorganisms can lodge in crevices Stand close to sink; turn on water with paper towel Sink is a source of contamination Using warm water and antibacterial soap, lather hands and wrists Rinse hands in downward position Dry hands; turn off faucet with paper towel 31
Alcohol-Based Hand Rub Recommended by the CDC for soiled hands Use preparations containing 60% to 95% alcohol Recommended use Before and after patient contact Before applying gloves and when removing gloves After contact with fluids or excretions, mucous membranes, wounds, and dressings When moving from contaminated portion of body to a clean site After contact with medical equipment 32
Procedure: Hand Sanitization Using Alcohol-Based Hand Rub Remove rings and watch Microorganisms can lodge in crevices Apply product to palm Follow manufacturer s recommended amount Spread gel evenly over hands, fingers, and wrists Rub until dry, approximately 15 to 30 seconds 33
Nonsterile Gloves Used for: Performing clean procedures Exposure to contaminated surfaces Reduce hand contamination by about 75% Prevent cross-contamination Protect patients and health care providers from infection Change before and after each patient encounter 34
Procedure: Apply and Remove Clean Disposable Gloves Select correct size Difficult to work if gloves don t fit properly Sanitize hands and apply gloves Remove gloves carefully to prevent contamination of hands Grasp outside of one glove with opposite hand, pull glove off, ball it in palm of gloved hand Insert fingers into cuff of remaining glove and pull glove off over palm holding balled glove from other hand 35